trust in healthcare · 2020. 9. 25. · icha : safe healthcare for all alliance for patient safety...

https://www.icha.in/

ICHA : Safe Healthcare for All

Alliance for Patient Safety

Dr. Akhil SangalCEO & DIRECTOR – Indian Confederation for Healthcare

Accreditation

TRUST IN HEALTHCARE

https://www.icha.in

Webinar on Patient Safety DayThursday, 17th September’2020

ICHA : Safe Healthcare for AllAlliance for Patient Safety

MECHANICAL vs. BIOLOGICAL“HEALTHCARE IS DIFFERENT”

• If you throw a stone – can you predict where it will land?

• If you release a bird from your hand – can you predict where will it land?

• Complex Adaptive Systems defy linearity• Nobility of Healthcare – Based on TRUST

– Knowledge – Fiduciary – Beneficience

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Missing Element in Healthcare Today?

�TRUST – WHY?� Manifestations

� Litigation� “Multiplicate” encounters� Violence� Dissatisfaction levels all around at

unprecedented levels“Ironically healthcare totally based on trust”

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Healthcare Excellence

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Trust Deficit Lack of Transparency

Not Taking Action on reports

Not “Walking the Talk”

Lack of Communication

INAPPROPRIATE CARELITIGATION – VIOLENCE – MULTIPLE OPINIONS ETC.


Lack Of Collaboration


TeamworkTeam work

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Lack of Coordination

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Patient safety§ The Safety Risks

� Physical� Mental� Financial

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Patient Safety Issues• "Errors" – Adverse reactions, Interactions,

Allergies and Prevention. • HAIs, wrong site surgeries, medications • Structural Aspects e.g. falls and injuries• Primary & Secondary Prevention• Financial - If Hospitalization is bankrupting, it

is a Public Health issue

• Appropriate care – most critical

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Missed Focus

� Inappropriate Care –IOM (Now NAM)

� Engaging Clinicians

� Engaging Patients

� The First Challenge – building trust to create culture.

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Current Consensus – The New Global Narrative

� Various agencies like NPSF, IHI, JAMA, AHRQ in US

as also in Europe and globally, as well as thought

leaders, are coming round to the realization that

creating a safety culture built on trust and

transparency is a pre-requisite for sustained safer

healthcare.

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CONFORMANCE – EXCELLENCE

If “Quality” is… Then Excellence is…

Conformanceto

standards

Conformanceto

standards

Wanting to conform

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Solutions� Back to Basics – Building trust & creating culture

� Trust, Transparency, Transactions

� Actions to improve

� Rewards & Recognitions

� Solutions based approach

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Solutions based approach

1. Fault-finding results in defensive reaction

2. In solution based approach we ask them to present the

best practice that they have.

3. Analyze the reasons for best practice

4. Gently redirect to do the same in other areas needing

improvement.

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“ERRORS” TO PSIs

� Makes Situation more Objective

� Prevents Pre-judgement

� Searching for WHY through “What”, “Where”, “When” and “How” rather than “WHO”

� Begin Reporting with “Near Misses”

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What is culture

Culture

Customs

BeliefsValues

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Stuart Matthews

Testing Safety Culture?

The way things are done around here….when no one is looking!

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FAIRNESS ALGORITHM1. Did the individuals intend to cause harm? 2. Did they come to work drunk or impaired?3. Did they do something they knew was

unsafe?4. Could two or three peers have made the

same mistake in similar circumstances?5. Do these individuals have a history of

involvement in similar events?


The 7 Steps to Patient Safety

� Step 1: Build a safety culture

� Step 2: Lead and support staff

� Step 3: Integrate risk management activity

� Step 4: Involve and communicate with patients and the public

� Step 5: Promote reporting

� Step 6: Learn and share safety lessons

� Step 7: Implement solutions to prevent harm

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Virtuous Circle of TRUST

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TRUST

TRANSPARENCY

TRANSACTION

COMMUNICATION

COLLABORATION

COORDINATION


Test of Trustworthy HCO

�My Mom’s Principle:

Would I get my Mom treated here if required?

OR Better Still

This is the first place I would take my Momto for treatment.

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Healthcare Excellence

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Take Home Message(s)

� Build TRUST� Through TRANSPARENCY and� TRANSACTIONS (Communication)� Build INTERLINKAGES� Stress BALANCE

�Consensus Based Guidelines“TINA Factor”

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Future – HCOs!– Enter at your own risk

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Let us for our own sake, join hands THANK YOU

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trust in healthcare · 2020. 9. 25. · icha : safe healthcare for all alliance for patient safety...

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